Obesity is not an answer to NHS funding issues

Scotland can't afford misinformation regarding obesity. Picture: TSPL

Allan Massie opines that we should encourage people to become fat and to smoke as it will save scarce NHS funds when they die young (The Scotsman, 10 June).

Many analyses confirm how obesity aggravates a host of chronic secondary diseases, quality of life and healthcare costs. None has remotely suggested that obesity improves anything, reflecting experiences of doctors, and the multiple chronic symptoms of obese people.

Massie declares the government prediction of 36 per cent obesity-prevalence in 2015 to be a lie. The 2013 Scottish Health Survey shows 27 per cent of all Scots to be obese according to BMI. However, many more with a “non-obese” BMI are “over-fat”, using a waist circumference measurement, a better guide to fatness and ill health than BMI. Currently 29 per cent of men and 47 per cent of women in more socially deprived families have worryingly elevated waist size.

Earlier predictions did not appreciate how greater inactivity would cause muscle wasting with age, so weight and BMI do not increase, even when people are getting fatter. Less muscle will promote more diabetes, more falls and more hip fractures, and thus more costs, to add to fatigue, arthritis, physical disability and depression.

Some 40 per cent of all Scots become obese by 65, and 70 per cent of them have secondary, chronic (and expensive) diseases. NHS spending doubles as BMI goes up from 20 (healthy) to 40 (severely obese).

It will be exciting to see how far Simon Stevens’s planned NHS programmes against obesity and diabetes can go in England, but we Scots have a record of leading the way in major public health improvements, including banning smoking in public places and moves to minimum pricing of alcohol.

Last week a meeting at the Royal College of Physicians in Edinburgh discussed innovative approaches to prevent and manage obesity. By working together we can protect our NHS with effective obesity prevention measures in Scotland. If there some necessary actions are uncomfortable for the food industry, it would be good to avoid spreading misinformation. The media, including The Scotsman, where many people obtain what they believe to be facts, can play valuable parts.

• Mike Lean is professor of human nutrition at the University of Glasgow